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Case Reports
. 2022 Feb;36(2):1302-1309.
doi: 10.1007/s00464-021-08405-1. Epub 2021 Mar 4.

Preaponeurotic endoscopic repair (REPA) of diastasis recti: a single surgeon's experience

Salvatore Cuccomarino  1 , Luca Domenico Bonomo  2 , Fabrizio Aprà  1 , Antonio Toscano  3 , Alberto Jannaci  1
Affiliations
Case Reports

Preaponeurotic endoscopic repair (REPA) of diastasis recti: a single surgeon's experience

Salvatore Cuccomarino et al. Surg Endosc. 2022 Feb.

Abstract

Background: Diastasis recti is a pathology that affects not only the abdominal wall but also the stability of lumbopelvic muscles, consequently altering urinary and digestive functionality. Preaponeurotic endoscopic repair (REPA) is an endoscopic alternative to tummy tuck for the treatment of diastasis. In this study, the outcomes of REPA application by a single surgeon are presented.

Methods: A total of 172 patients underwent REPA for the treatment of diastasis recti between August 2017 and December 2019. One hundred twenty-four patients were followed for at least one year. Sixty-three patients responded to a survey on satisfaction and quality of life 12 months after surgery.

Results: Three (2.4%) recurrences occurred, of which two occurred in the same patient. The main postoperative complications observed were 12 (9.7%) seromas, 3 (2.4%) haematomas, a single wound infection, 3 (2.4%) cases of skin fold formation, and a case of trophic skin lesion that required negative pressure therapy. Quality of life after surgery, as reported by 63 patients who responded to the survey, was satisfactory.

Conclusions: REPA is a safe and effective technique for diastasis recti treatment, representing a valid alternative to abdominoplasty. Since there is no need to access the peritoneal cavity and the mesh is onlay, there are no risks of bowel damage or adhesions between the intestine and prosthesis.

Keywords: Abdominal wall defects; Diastasis recti; Onlay mesh; Preaponeurotic endoscopic repair; Recti plication.

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